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Title Specialty Votes Comments Rating

Mental health parity law

I've see these laws passed in various states without much change in actual benefits due to the "carve out mental health managed care" companies that review ...		 Politics & Reform 103 64

Chest pain / palpitations and ADHD meds

Since the hubbub about heart disease and stimulent ADHD meds, I have been askng more questions on review of systems about chest pains and palpitations and ...		 Pediatrics 60 34

wait time to confirm or rule out occult elbow fracture

I have a 12 yo girl who injured her elbow cheerleading. Initial xray showed joint effusion but no frank fracture. I have placed her in a splint and plan ...		 Orthopaedics 60 72

Twice daily PPI therapy in GERD patients

A few patients in my practice have responded well to twice daily PPI therapy as maintenance for endoscopically confirmed GERD with erosive esophagitis. I u...		 Gastroenterology 23 36

treating orthostatic hypotension with severe hypertension

Hi,I have a patient with the following situation:1. Severe hypertension when supine (SBP > 200)2. Severe symptomatic hypotension with SBP as low a...		 Nephrology 96 5

Sudden onset hirsutism

It seems like all the puzzling cases are coming in one big wave.I have a pleasant 72 y/o white female referred to me for eval of new onset hirsutism. Sh...		 Endocrinology 102 24

Pregnant patient with palpitations

27 y/o G2P0A1, 26 WGA presents to the ED after sudden onset of palpitations that started about 1 hour prior to arrival while in a swimming pool. States ass...		 Emergency Medicine 67 31

Metastatic Gallbladder cancer or primary ovarian

I have a 63 yo female who underwent a routine cholecystectomy 2 years ago. Pathology demonstrated a well differentiated papillary adenocarcinoma of the gal...		 Pathology 68 80

Chest Pain in the ER....standard of care?

Okay. I'm a hospitalist (program director) and I moonlight in the ED as they need the help. In what is a funny twist of fate, I am the ED attending when my PA...		 Hospitalist 33 50

Any thoughts for profound endometriosis?

I have a 25 yo G2P2 with a confirmed h/o by LSC of endometriosis. She is actually one of our OR nurses. I don't have all of her recored from her previous prov...		 OBGYN 37 18

Approach to Adolescent Depression

This is primarily for primary care physicians who take care of adolescent patients. I have a good number of adolescent patients. Some have major depression...		 Family Medicine 32 48

Sermo Case Conference in ER: 60 yo w/ epigastric pain x 1hr

The following case is part of the Sermo Case Conference Series in Emergency Medicine. This case will unfold over several days - feel free to ask for additional ...		 Case Conference 31 19

Sermo Case Conference in MSK Medicine: 43 YO F w/ groin pain

History of Present Illness: 43 year old female with history of axial low back pain s/p L4/5 microdiscectomy for left sided radicular pain in 2003, now with 4 mo...		 Case Conference 38 8

Sermo Case Conf in Neurology: 45 YO M w/ HIV & headache

History of Present Illness: A 45-yo male complaining of a dull and persistent headache for the past 2 days. This headache is new for him although he had headach...		 Case Conference 80 77

Obstructive Sleep Apnea in children

I recently had a 6 yr old girl in the ED referred by a peds neurologist for further evaluation for narcolepsy.As per mother the teacher complained that ...		 Pediatrics 17 5

Hyperprolactinemia case

I was referred a 38 year woman for evaluation of elevated PRL. The presenting complaint was secondary amenorrhea, for ~8 years.There was no work-up, pre...		 Endocrinology 68 103

24 week pregnant patient with creatinine stable at 7!

Hello,I just got a call from a Maternal fetal medicine (MFM) doctor about the following case.28 y/o hispanic female who is an illegal alien in the U.S. ...		 Nephrology 33 28

Does ORAL hydralazine work well for blood pressure?

Hi,I am board certified in hypertension and half of my practice is treating hypertensive patients.I have found that IV hydralazine generally works v...		 Nephrology 17 47

Adjuvant hormonal therapy early stage breast cancer

50 year premenopausal female, no real family history, had atypical ductal hyperplasia and LCIS (ER+/PR+) right breast 2006 and placed on Tamoxifen. Developed ne...		 Oncology 57 87

Need help with clinical case in 40 yo with back pain NYD

Dear All,I wanted to pose this interesting history on a 40 yo male who presents with rt sided lower back pain post surgery. He had a right sided L5-S1 ...		 Orthopaedics 5 93

Thyroid lesion lighting up in a PET scan

65 + year old White male referred for eval of a thyroid nodule that lit up on a PET scan. I just saw him this week and dont have any of the records availabl...		 Endocrinology 52 39

Advanced polyps in a young woman

I want to get some input out there. I have a 30 yr old woman who I did a colonoscopy for rectal bleed. She had a 3.5 cm sessile VTA in the sigmoid, 3 cm carpe...		 Gastroenterology 37 72

Post menopausal bleeding with bleeding intracavitary myoma

78 y old Hindu women, healthy with sudden heavy bleeding,25 years into menopause.Hysteroscopy reveals a very large, vascular, intracavitary myoma occupying ...		 OBGYN 71 74

Unilateral Subareolar Swelling in a 14 yr old male

A 14 yr old african american male comes to you after he has noticed a 2 cm swelling beneath his right nipple, in the subareolar area. It is soft to firm in cons...		 Pediatrics 56 89

2nd episode of jaundice

My 43 yo male patient saw me this week with what I thought might be acute Hep A, but the Hep A IgM was negative. Thoughts?Pt only past medical hx is nephrot...		 Internal Medicine 56 22

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